Stent in the brain promotes strokes

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When a blood vessel in the brain becomes blocked, a stent is supposed to help keep it open. In fact, the risk of another stroke increases.

An international research team led by Osama Zaidat from the Medical College in Wisconsin compared two different forms of therapy after a stroke in a study: 53 patients received drug treatment with the blood thinners clopidogrel and ASA; the participants in group two were each implanted with a stent with a balloon catheter. In addition, they were given the same medication as group one. All patients were examined regularly for at least one year after therapy.

Three times as many strokes

The surprising result: the stent did not bring any improvement, but performed significantly worse than the pure drug treatment. One year after treatment, 34.5 percent in the stent group but only 9.4 percent in the drug-only group had suffered another stroke. Most of these events occurred in the first 30 days after the stent was implanted.

The drug group did not suffer from cerebral haemorrhages during the entire observation period; this happened five times in the stent group. In addition, three deaths were recorded in the patients with stents within the 12 months; none of the participants treated with drugs alone died during the study period.

Like a snow plow in the brain

But what is the reason for the poor performance of the stent? The scientists suspect that treatment shifts the problem, so to speak. When inserting the stent, deposits on the blood vessel wall, so-called plaques, could be scraped off and pushed into adjacent blood lines. They can then become clogged and this triggers another stroke. (away)

Source: Zaidat O. et al .: Effects of a balloon-expandable intracranial stent vs medical therapy on risc of stroke in patients with symptomatic intracranial stenosis, JAMA, 2015.

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